Ivermectin for COVID-19: What’s the Dose?

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Critics of the use of ivermectin for prevention or treatment for COVID-19 point out potential flaws in the supportive scientific studies. A few of these critiques are:

  • small size of experimental and control groups
  • lack of a reasonable control group; e.g., if everybody in the U.S. is vaccinated for COVID-19, we won’t have a control group to help us determine true long-term consequences of vaccination or lack thereof
  • not accounting for changes concurrent with the experiment; e.g., lockdowns, mask-wearing compliance, natural waxing/waning of viral surges
  • excessively complicated study design; e.g., using doxycycline or azithromycin or a steroid along with the ivermectin
  • the chosen doses of ivermectin are all over the map

The non-standard doses of ivermectin are maddening, but understandable. We’re trying to re-purpose a drug that’s already FDA-approved for several indications. Physicians already prescribe numerous drugs where the dose depends on age, weight, renal function, liver function, etc. Big Pharma spends millions of dollars per drug to figure this out when a drug is patent-able. But who’s going to pay for that when the drug is off-patent, like ivermectin? It’d be nice if the CDC or FDA did. We’re already a 18 months into this pandemic.

If ivermectin works at all for COVID-19, the dose for prevention may be different than for treatment. The following are some oral doses I’ve run across, mostly from positive clinical studies. “Kg” means body weight in kilograms. “Mg” means milligrams. If you can’t convert between milligrams and micrograms in your head, do it here. Many ivermectin proponents recommend starting treatment early, especially if there are co-morbidities.

Prevention of COVID-19

  • at least 150 microgram/kg per week
  • 12 mg (~150 microgram/kg) monthly or every 42 days

Treatment of COVID-19 Whether or Not Hospitalized

  • 200 to 1200 microgram/kg daily for three to seven days
  • 0.2 mg/kg (200 microgram/kg) on Day 1 and Day 3 (plus Days 6 and 8 “if not recovered”)
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)
  • 18 to 36 mg daily or every other day for between 1 and 5 doses (Drs Orient and Vliet with help from McCullough)
  • 0.4-0.6 mg/kg daily for five days or until recovered (I-MASK+ and MATH+)

Treatment of COVID-19 in Hospitalized Patients

  • 200 microgram/kg on Day 1 (plus 200 microgram/kg on Day 7 at physician’s discretion) (Broward Health hospitals study)
  • single dose of 0.15 to 0.4 mg/kg
  • 200 microgram/kg single dose
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)

See, doses vary wildly. And don’t ask me if dose should be based on ideal rather than actual body weight.

You probably know that you can often get ivermectin without a prescription. Many countries have decided it’s safe enough to sell over-the-counter.

I’m not recommending ivermectin to you or anybody else. I’m not your doctor. Only your personal physician who knows you, your lab results, your physical exam, and your medical history is in a position to recommend drug therapy.

Steve Parker, M.D.

One response to “Ivermectin for COVID-19: What’s the Dose?

  1. Pingback: Ivermectin for COVID-19: What’s the Dose? — Advanced Mediterranean Diet – Pynez9ja

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